Posts Tagged ‘Behavior change’

Pharma: Build “Around the Pill” not “Beyond the Pill”

For several years, pharma has attempted to move “beyond the pill” to offset declining product pipelines. The dream is to find new revenue opportunities. New business models.

But as we’ve seen, these new products and service experiments are rarely commercialized. If you study the revenue mix on any pharma P&L statement, you’d be hard pressed to find any real revenue beyond pills.

So, what’s the problem?

Well, it’s not just pharma. Successful new businesses that launch in the shadow of large legacy product portfolios are rare in any industry.

$100 Million or Bust
A few years ago, I was working with a global CPG company with a vibrant innovation team. But the success bar for moving a new idea or business model out of the lab was having visibility to least $100 million a year in revenue. Soon.

This meant that only the most obvious, non-risky ideas got the capital needed to grow. Promising but speculative projects were left to die on the vine.

So the challenge of commercializing innovation is not unique to pharma, but that doesn’t let us off the hook. There is an urgency to figuring this out.Around the pill

The Urgency has Changed
A few years ago the focus was on finding new ways to backfill declining revenue from the patent cliff. But now the product pipelines for biologics and new orphan drugs for rare diseases could not be more robust. Revenue is growing again.

The real reason for today’s urgency is not revenue, it’s the changing customer environment. We now have the need to not only prove outcomes but to improve the patient experience. Soon.

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The Land of Oz

Dr. Oz and celebrity doctors like him have stirred up the medical community. Regardless of what you think about the accuracy of Dr. Oz’s claims and advice, he has created a huge audience of four million viewers who look to him for medical, health and nutrition advice.

While I don’t have the clinical background to judge the truthfulness of Dr. Oz’s advice, I do know that he’s leveraging media and technology in a very fresh and powerful way to enable and support patient empowerment. His platform puts medical and health information into the hands of millions of consumers. Dr. Oz’s approach is filling an unmet need in the medical community: helping patients to truly learn and understand their health.

OzThe Perfect Storm
It really is a perfect storm of trend, technology and media. Patients really want to understand how to live healthier, and cable television and digital media and apps have made access to fresh content cheap, convenient and ubiquitous. But this shift has upset the natural order of traditional patient-doctor relationships.

Physicians working in the traditional health care system are often overburdened and don’t really have the bandwidth to create new ways of doing things. So along comes a physician, Dr. Oz, who is able to break down health, healthcare and medicine in very simple ways that make it accessible to the population – and consumers are embracing that. The magic of Dr. Oz’s approach is that it’s engaging, accessible, simple and motivating.

What can we learn from Dr. Oz?
While there has been negative press about Dr. Oz’s endorsements of weight-loss products, there are people, particularly those who may not have a primary care physician, who use his advice to make decisions about their health. So before we attempt to silence or disparage him, I think it is better for us to look at what Dr. Oz is doing right and what we can learn from his success, especially at the physician level. What can physicians learn from Dr. Oz’s simple, clear explanations of what’s happening in the body, and how can they incorporate that into their patient relationships?

The patient empowerment movement isn’t going away, and we shouldn’t want it to, so it is important for physicians to embrace the patient’s willingness to learn and understand medicine and how it affects their bodies.

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What will make Patient Data Meaningful to Patients and Physicians?

In my last blog posting I noted that the thousands of health apps available today are beginning to generate good, accurate patient data. But just because the data is accurate doesn’t mean it’s meaningful. Especially when it collides with the real world of the healthcare professional.

There are three important issues that need to be addressed before this surfeit of personalized patient data becomes useful and meaningful to both consumers and physicians.

Data Overload
The first concern is just data overload. As patient devices become interoperable with each other and with EMR systems (a good thing), they will dump raw data, whether it’s heart rate, blood pressure, glucose level, etc. right into the physician’s office. And frankly, doctors just don’t have enough hours in a day to be able to look at and process that information.

If you follow most internists today, they’re in the office all day seeing 15, 20, even 25 patients and then in the evening they’re spending three hours reviewing their notes and lab reports or they’re logged onto their patient portal site to respond to the two dozen patient emails they received that day. We can’t ask them to now review and respond to potentially dozens of patient data streams. Read Full Article Now »

Three Steps To Restoring Relationships in Pharma after a “Pinch”

At closerlook, we think a lot about relationships. We think about those that we have with our pharma clients, those that our clients have with their customers and especially those that we have with each other in the office and with our business partners. Healthy relationships are important for the business ecosystem. Therefore, it’s invaluable to know what to do when a relationship is not going well.

pinch3When there’s a “pinch” in a relationship, it can go one of two ways:

  1. It can lead to frustration, mistrust and ultimately the demise of the relationship.
  2. It can actually become an opportunity to redefine and strengthen the relationship.

Here are three strategies to use before, during, and after a pinch to increase the odds of a good outcome:

1) The Goodwill Bank

Relationships are never perfect. Even in the best relationships, things happen that will challenge that relationship.

Recognizing this, it’s very important to keep a strong balance of goodwill in the relationship bank. This will ensure that there are enough reserves so that when there is a pinch and a subsequent draw down of goodwill , you don’t go into overdraft mode.

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Three Key Strategies to Drive Better Patient Care

When it comes to health technology and new mobile apps, we often jump right into a discussion about cool features and social media. But the real question should be impact. What positive impact are we having on patients and their physicians, the ultimate gatekeepers?

The bottom line for most physicians is efficiency: “How can I be more productive with the time I have with my patients given the clinical load I carry?” Therefore, a good place to start in any technology impact discussion is how to enhance the physician-patient interaction to make it better and more efficient.

There are three important activities that influence physician efficiency:

 1) Precise diagnosis of ailments

 2) Patient education support

 3) After-care compliance and home monitoring

These are also three activities that can have a significant influence on patient outcomes.

All three of these are time-consuming but critical activities, and all of them can benefit greatly from technology.

1) Precise Diagnosis

Stopwatch1During the typical 15-minute office visit, in addition to collecting as much medical and family history as possible, physicians will review a patient’s symptoms. Very often they’re listening for that random clue that might influence the diagnosis, something that maybe the patient hasn’t thought of or hasn’t remembered since the last office visit.

When a patient walks in a doctor’s office, particularly if they don’t have a caregiver with them, they often are stressed and very often forget or misread symptoms that might have happened at home. It’s kind of like when you take your car into the shop and suddenly that engine knock isn’t there anymore, and the garage guy rolls his eyes and tells you to bring it back when there is a real problem.

Technology can play a supportive role here by capturing a wide range of patient symptoms as they are experienced at home, at work or socializing with friends.

One solution to this challenge is an mHealth (mobile health) iPhone-based symptom tracker. A mobile app can capture relevant patient experience data and efficiently provide it to the physician to inform the diagnosis – information that the patient might not even remember or consider important. By providing additional diagnostic clues, a symptom tracker will enhance the conversation about health between the physician and patient.

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The Nature of Superpowers

I recently spent two hours in a conference room with some really smart people and three accomplished musicians from a young, innovative Chicago-based chamber orchestra called Fifth House Ensemble. We talked about the nature of the professional musician and what it takes to become world class.

The leader of Fifth House suggested that the world’s best musicians have four “superpowers” in common:

Self Knowledge

“I picked this path, and I’m committed to it.”Superpowers

Professional musician generally choose their artistic path as early as four years old. Most of the rest of us are not picking our careers when we’re that young, but the concept is still very relevant. Do we know exactly who we are, what career we’re creating, and what kind of impact we’re having in the world?

2) Self-Discipline

Musicians all over the world practice two to six hours a day every day just to maintain their skill. More practice time when they are learning a new technique or piece of music. And they do this from the time they’re four years old. It’s really good for creating muscle memory, but it does require extraordinary self-discipline to spend hours every day in a solitary practice room. This single-mindedness begins to affect how they observe and experience the world, putting much of what they see and hear in terms of music and rhythm, tone and emotion.

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Pharma Brand Managers, Are You Fungible?

In pharma, the focus is always on market share, market share, market share.  Managers are measured by growth and their ability to counter new competitive entrants and offset contracting pressures by private and government payers. Because of this, product differentiation is an important role for marketing. There is widespread fear of becoming a “me-too” commodity drug.

But while the focus of pharma brand teams is on avoiding product commoditization, little attention has been paid to that same danger for the brand manager.

There’s a real danger that brand managers themselves could become commoditized.

“Commodity” is the point when a product or a service is “fungible.” In other words, it can be easily replaced by a substitute. Substitution is the biggest threat to any product or service, because when the buyer (or, in this case, the employer) doesn’t perceive any significant differences between alternatives, they buy strictly based on lowest price.

As pharma management feels the effects of margin pressure on their business, they will look for ways to consolidate or eliminate redundant positions. They will look for ways to substitute expensive talent with technology, lower cost employees, or consolidated roles. In each case, it’s the employee with little to show that’s unique and valuable whose job is suddenly at risk.

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Proxies will have to do

During a recent planning call for a patient disease management program the discussion turned to metrics. Key to any program design is agreement on what outcomes will be measured and what will be deemed success. It makes no sense to launch a program without developing goals about levels of engagement, target clinical results, and ultimately financial payback.

So far so good, right?

Until we moved beyond vague generalities about impact and tried to identify the actual sources of patient data that would validate the program.

  • “We only get about 10% of the patient lab results we request.”
  • “We attempt to get physicians to attest to patient check-ups in writing, and you know how that goes.”
  • “Legal has deep concerns about merging patient data sources.”

So how then do these brands continue to sell expensive patient programs without validated outcomes?

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Keeping America Well

The internet has revolutionized retail. In travel, consumers use self-service websites to search for destinations, compare offers and purchase a vacation. Amazon has replaced the knowledgeable bookstore owner with breadth and convenience. Yes there are trade-offs, but most consumers are willing to exchange professional expertise for price and convenience on non-critical decisions.

But not so with healthcare. Yes, consumers go online when they have a health question, but sometimes they leave more confused than before. Convenience yes, but expertise? Questionable.

If you ask Dr. Roy Schoenberg, CEO of American Well Systems, he’ll tell you why. “In the consumer’s mind, healthcare is not online portals or health risk assessment tools. Healthcare is about talking to a doctor.” We receive healthcare when we explain our symptoms to a physician, he or she diagnoses the problem and then recommends a remedy.

There’s still a convenience problem, however. Often at the point of need, many of us can’t get in to see our doctor. It may be 2:00 a.m. and your child is crying, or you are experiencing pain and your doctor’s calendar is booked for the next three weeks.

But what if you could log on to the internet (convenience) and talk live with a physician (expertise)? And what if that physician could call up your health records as the connection was being made? And finally, what if this “doctor’s visit” was covered by your health insurance (price)?

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Learning How to Nudge

Still exercisingIn a recent article in the Wall Street Journal, a Ms. Ruthanne Lowe from San Jose, CA reported that three years after her participation in a Stanford University study on behavioral change, she is still exercising. The study showed that even just a gentle nudge can have a positive effect on motivation.

The issue of how to support patients with chronic illnesses is back on the healthcare front page. Studies show that even if a patient sees a doctor, gets diagnosed, and receives a care plan, whether a drug or a regimen like diet and exercise, up to 50% of those patients will elect not to follow through. The prescription won’t be filled or the healthy life choices won’t be followed. So even if 32 million new consumers in our new health care world get access to a physician, half of them likely won’t take their meds as prescribed.

That’s a big problem.

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